Efficacy of Platelet-Rich Plasma Therapy in Oral Lichen Planus: A Systematic Review.

Background and Objectives: Oral lichen planus (OLP) is an autoimmune, mucocutaneous, oral potentially malignant disorder (OPMD), which characteristically manifests with chronic, recalcitrant lesions, with frequent flare-ups and remissions. The precise etiopathogenesis of OLP is still debatable, although it is believed to be a T-cell-mediated disorder of an unidentified antigen. Despite the availability of various treatments, no cure for OLP exists due to its recalcitrant nature and idiopathic etiology. Platelet-rich plasma (PRP) has antioxidant, anti-inflammatory, and immunomodulatory properties, in addition to its regulatory action on keratinocyte differentiation and proliferation. These salient properties substantiate the possible role of PRP in the treatment of OLP. Our systematic review focuses on assessing the therapeutic potential of PRP as a treatment modality in OLP. Materials and Methods: We conducted a detailed literature search for studies assessing PRP as a therapeutic regimen in OLP, using the Google Scholar and PubMed/MEDLINE search engines. The search was limited to studies published from January 2000 to January 2023 and included a combination of Medical Subject Heading (MeSH) terms. ROBVIS analysis was carried out for the assessment of publication bias. Descriptive statistics were performed using Microsoft Excel. Results: This systematic review included five articles that met the inclusion criteria. Most of the included studies demonstrated that PRP treatment considerably ameliorated both objective and subjective symptoms in OLP subjects, with comparable efficacy to the standard corticosteroid treatment. Further, PRP therapy offers the added benefit of minimal adverse effects and recurrences. Conclusion: This systematic review suggests that PRP has significant therapeutic potential for treating OLP. However, further research with larger sample sizes is imperative to corroborate these findings.

Mucoepidermoid Carcinoma of Minor Salivary Gland in a Patient with Asymptomatic Palatal Swelling - A Case Report.

Incidence of abundant minor salivary gland tissues in the posterior part of hard palate surges the likelihood of salivary gland neoplasm especially in this part of the oral cavity. Minor salivary gland tumor accounts for virtually 15% of all the salivary gland neoplasm, wherein mucoepidermoid carcinoma comprises of 35.9%. Current paper reports a case of mucoepidermoid carcinoma of the posterior part of the hard palate which was an incidental finding. It presented as well-defined smooth swelling, the preliminary radiographic investigation revealed no appreciable bony changes and offered an impression of a benign tumor. Histopathological investigation displayed features of mucoepidermoid carcinoma of intermediate grade. The lesion was surgically excised and the patient was under regular follow up for 3years. The paper focus on the magnitude of swift clinical diagnosis of specific lesions, so increasing the survival rate and reducing the morbidity.

Bond assessment of enamel conditioned with Er, Cr: YSGG laser and methylene blue photosensitizer activated by photodynamic therapy to orthodontic metallic brackets.

AIM: To assess bond integrity and failure mode after enamel pretreated with conventional and contemporary conditioning methods were bonded to metallic brackets (MB). MATERIAL AND METHODS: Forty maxillary central incisors were selected and disinfected. All specimens were mounted up to the cement-o-enamel junction and divided into four experimental groups randomly based on the enamel conditioning technique. Photodynamic therapy (PDT) was used to condition enamel in group 1, Total-etch and rinse (TER) was used to treat samples in group 2, Specimens in group 3 were conditioned with ECL, and samples in group 4 surface pretreated with SEP. Bonding of MB was performed on the surfaces of all the specimens with a Transbond XT. Specimens from all investigated groups were positioned on a universal testing machine maintaining buccal surfaces similar to the direction of the force. After bracket debonding bond failure was assessed using ARI. The bond integrity of all four groups was compared using analysis of variance (ANOVA). Post hoc Tukey test was used for pairwise comparison among different groups. RESULTS: Group 2, TER+MB (15.38±0.14 MPa) displayed the highest bond value whereas the lowest values of SBS were exhibited by group 1, PDT+MB (10.11±0.17 MPa). The inter-group comparison revealed that specimens of group 2 and group 3, ECL+MB (14.61±0.55 MPa) demonstrated comparable bond strength (p>0.05). CONCLUSION: Enamel conditioned with TER and ECL demonstrated comparable SBS. However, bond integrity after PDT and SEP (self-etch primer) surface treatment of enamel bonded with MB significantly lowered bond values.

Oral Hygiene Myths and its Association with Gingival Health Status among Patients in Aseer Region of Saudi Arabia: A Cross-sectional Study.

AIM AND OBJECTIVE: The aim of the study is to assess "Myths in dentistry related to Oral Hygiene and its association with Gingival Health Status among patients visiting Institutional diagnostic clinic in Aseer region of Saudi Arabia." MATERIALS AND METHODS: The present study was a cross-sectional study done on 152 subjects attending Institutional diagnostic clinic in Aseer region Saudi Arabia. Myths in dentistry related to oral hygiene were assessed by using a ten-item, multiple-choice, close-ended structured questionnaire and Gingival Health Status was assessed using gingival index described by Loe and Silness on the Ramfjord teeth. For the comparison of proportions, a Chi-Square test was used with continuity correction whenever appropriate. "p" value of <0.05 was taken to be statistically significant for the purpose of analysis. RESULTS: A total of 152 study subjects were included in the study, of which 60.5% were males and the rest 39.5% were females. Eighty-two percent of the study subjects believed that myths do affect the oral hygiene of the person. Combinational use of household ingredients (like apple vinegar, turmeric, lemon, baking soda, coal, honey, and sodium bicarbonate) was seen among 40% of the subjects. A majority of 48% learned from family as a source of information and 53% believed that use of household ingredients would improve the esthetical value (bleaching) of the tooth. Eighty-two percent of the study subjects believed that myths do affect the oral hygiene of the person. 40.8% had some form of gingival health problem. There was no statistically association observed between myths in dentistry related to oral hygiene and gingival health. CONCLUSION: The present study revealed that myths in dentistry related to oral hygiene are quite prevalent in society. The use of household ingredients can influence oral health status and one has to ensure the judicious use if good oral health is to be expected. CLINICAL SIGNIFICANCE: Myths in dentistry related to oral hygiene can influence a lot on oral health and this can augment the health of the individual in any direction. So as a responsible clinician, it is very important to address these issues and bring in more health awareness among the study population to achieve the social goal-"health for all." How to cite this article: Assiri KI, Ajmal M, Al-Ahmari BM, et al. Oral Hygiene Myths and its Association with Gingival Health Status among Patients in Aseer Region of Saudi Arabia: A Cross-sectional Study. J Contemp Dent Pract 2021;22(5):506-510.

Effect of ultrasonic scaling with adjunctive photodynamic therapy on the treatment of gingival inflammation among diabetic patients undergoing fixed orthodontic treatment.

BACKGROUND: The aim of the present clinical trial was to evaluate the effect of methylene blue-mediated antimicrobial photodynamic therapy (aPDT) on the gingival and immunological parameters in diabetic adolescent patients undergoing fixed orthodontic treatment. METHODS: The selected 40 participants were randomized equally into two groups; Group I (ultrasonic scaling + oral hygiene instructions) and Group II (ultrasonic scaling/oral hygiene instructions + aPDT). Serum HbA1c levels was assessed for all the participants at chairside. Plaque index (Pi), and bleeding on probing (BOP) were analyzed. Moreover, the assessment of crevicular fluid matrix metalloproteinase 8 (MMP-8) and macrophage inflammatory protein 1 alpha (MIP-1α) was performed using enzyme-linked immunosorbent assay technique. All measurements were recorded at baseline, 6 weeks, and 12 weeks follow-up periods, respectively. Intergroup comparisons for p-value were computed using Mann-Whitney test and Wilcoxon singed ranks test to compute p-value for intra-group comparisons. Stepwise logistic regression analysis was used to identify explanatory variables for reduction in plaque scores and bleeding on probing, after controlling for the effects of other covariates. Odds ratios and 95% confidence intervals were used to assess the direction and strength for associations. Significance level was set at 5% for all analyses. RESULTS: All 40 individuals completed the clinical trial. There was a statistically significant reduction in Pi and BOP in both Group I and Group II from baseline to 12 weeks of follow up (P<0.05). However, there was slight reduction in the plaque scores in Group-II as compared to Group-I at 12 weeks visit (P<0.05). There was also a statistically significant difference for BOP when Group-I was compared with Group-II on 12 weeks follow up assessment (P<0.05). HbA1c assessment indicated no statistically significant difference either within or between groups at any time point (P>0.05). Both MMP-8 and MIP-1α reported a significant decrease for both Groups I and II at 6 weeks and 12 weeks follow-up periods in comparison to baseline (P<0.05). Inter-group comparison indicated a statistically significant difference noted at both 6 weeks follow up that was maintained at 12 weeks follow up (P<0.05). The logistic regression analysis revealed that even after controlling the mean BMI as a predictor, the change of biomarker levels along with the improvement in plaque scores and bleeding on probing was not significant (p> 0.05). CONCLUSION: aPDT significantly improved bleeding on probing and proinflammatory biomarkers among diabetic adolescent patients undergoing fixed orthodontic therapy.

Effectiveness of photodynamic therapy as an adjunct to topical antiviral therapy in the treatment of herpes labialis: A randomized controlled clinical trial.

BACKGROUND: The present clinical trial assessed the effectiveness of photodynamic therapy in association with topical acyclovir in the treatment of herpes labialis in adolescent patients. MATERIALS AND METHODS: 45 individuals with herpes labialis were divided into three groups on the basis of provision of treatment. (a) Group I: Topical acyclovir therapy (AVT) (n = 15, mean age: 17.5 years) (b) Group 2: photodynamic therapy (PDT) (n = 15, mean age:16.8 years) and (c) Group III: AVT + adjunctive PDT (n = 15, mean age: 17.0 years) respectively. HSV-1 quantification and pain scales [visual analogue scale (VAS) and McGill Pain Questionnaire (MPQ)] were calculated. Pro-inflammatory biomarkers including interleukin (IL-6) and tumor necrosis factor-alpha (TNF-α) were quantified using enzyme linked immunosorbent assay (ELISA). Shapiro-Wilk test was used to assess the normality. The Friedman test was employed to compute the comparison for changes recorded in pain scores, proinflammatory cytokines and HSV-1 quantification, whereas Mann-Whitney test was used to analyze the mean values and establish inter-group comparisons. All assessments were performed at baseline, immediate post op, 2-weeks, 4-weeks, 3-months, and 6-months. RESULTS: A total of 44 individuals completed the clinical trial. According to the data obtained from the clinical assessment, all the study groups reported a decrease in the parameters being observed. However, Group III (anti-viral (acyclovir) therapy + adjunctive PDT) showed a statistically significant decrease, in comparison to Group II (PDT) and Group I [AVT] respectively. The quantified HSV-1 among all groups showed significant reduction among all groups at each successive follow-up. However, Group-III (AVT + PDT) showed statistically significant reduction as compared to Groups I and II, respectively (p < 0.05). CONCLUSION: Topical anti-viral therapy with adjunctive PDT significantly helped in reducing the pain and pro-inflammatory biomarkers in adolescent herpes labialis patients.

Efficacy of root canal treatment in c-shaped canals with adjunctive photodynamic therapy using micro-CT.

AIM: To investigate the efficacy of conventional root canal treatment (cRCT) with adjunctive photodynamic therapy (aPDT) against microbial biofilms within infected c-shaped root canals. METHODS: In this in vitro report, the inoculation of 20 freshly extracted human mandibular molar teeth having c-shaped root canal configuration was performed with E. faecalis and P. aeruginosa to produce three-day biofilms in prepared canal system. PDT used a combination of chlorin (ce6) and polyethylenimine (PEI) as the photosensitizer (PS). A 200 µ-fiber was employed to deliver a 660 nm diode laser light into the root canal, and this was compared and conjugated with conventional endodontic treatment utilizing antiseptic irrigation and mechanical debridement. RESULTS: The utilization of aPDT (group-2) resulted in a considerable decrease in the count of E. faecalis and P. aeruginosa from 12.84 ±â€¯2.18 CFU/mL to 5.13 ±â€¯0.67 CFU/mL, and from 14.06 ±â€¯3.98 CFU/mL to 4.82 ±â€¯1.05 CFU/mL pre-and post-treatment, respectively. A statistically significant reduction in the bacterial counts of both microbes was observed after treatment among the samples of the both study groups (p < 0.05). Specimens in group-2 (8.42 ±â€¯1.14 MPa) demonstrated the highest mean push-out bond strength, whereas the lowest was shown by samples in group-1 (7.08 ±â€¯1.09 MPa). ANOVA showed no statistical difference between the research groups (p = 0.676). The independent t-test revealed that the mean push-out bond strength scores of the cervical segments were higher than the apical and middle segments of roots in research groups (p < 0.05). CONCLUSION: In c-shaped root canals, the application of photodynamic therapy as an adjuvant to conventional root canal treatment contributes to a statistically significant decrease in the microbial count of E. faecalis and P. aeruginosa along with an improved push-out bond strength of the root canal filling material with root.

Correlation of Buccal Micronucleus with Disease Activity Score Using Buccal Micronucleus Cytome Analysis (BMCA) in Systemic Lupus Erythematosus.

BACKGROUND: A disease activity score obtained by using systemic lupus erythematosus disease activity index (SLEDAI) has traditionally been a reliable method to assess the SLE status of patients. More recently, a buccal micronucleus cytome assay (BMCA) has been developed for use as a biomarker of DNA damage in patients with SLE. There has been a very limited number of studies pertaining to the oral lesions in Arab population suffering from SLE in Asir region. Hence, it became utmost important to study epidemiological data of oral mucosal lesions in SLE patients. Distribution of oral lesions in SLE patients could also be helpful in better management of oral complications. AIM: The aim of this study was to determine the existence of a correlation between SLEDAI score and the degree of micronuclei (MN) formation using BMCA. MATERIALS AND METHODS: After thorough oral examination of adult Saudi SLE patients of Asir hospital and that of healthy control subjects, the subjects underwent BMCA from normal unaffected bilateral buccal mucosae. RESULTS: Pearson's correlation test showed that MN count did not significantly correlate with either disease activity or duration of SLE. CONCLUSIONS: Controlled state SLE does not lead to a significant increase in MN formation. Thus, the occurrence of premalignant lesions in the oral cavity could be minimized using proper management protocols.

Prevalence and psychological stress in recurrent aphthous stomatitis among female dental students in Saudi Arabia.

INTRODUCTION: Recurrent Aphthous Stomatitis (RAS) is a common oral mucosal disorder which is characterized by recurrent ulcerations mainly confined to non-keratinized oral mucosa. Though the exact etiology is imprecise, stress and anxiety were found to be linked with the onset of RAS. The present study was directed to know the prevalence of RAS among female dental students in King Khalid University, to find out the association between RAS and psychological stress and the effectiveness of Hospital Anxiety and Depression scale (HADS) in finding out the psychological profile of RAS patients. METHOD: 122 female dental students of age group 17 to 25 years were selected for the study. Subjects with relevant medical problems and deleterious habits were excluded. A questionnaire comprising general stress related questions and HAD scale were used to assess stress. Those who were giving history of ulcer were diagnosed as RAS based on the clinical features. The questionnaire results were used for statistical analysis and processed. RESULT: 14% of the total students were having RAS. 70% could correlate the onset of ulcer with certain specific factors; stress being the major causative agent (91%). In HAD scale, 88% of students were having anxiety and 65% had depression; all patients with depression had anxiety. CONCLUSION: The prevalence of RAS in female dental students in KKU was around 14%. There is a strong relationship between psychological stress and RAS, as in most of the other studies. HAD scale alone can be used for detecting the psychological factor in RAS.

Subjective image quality comparison between two digital dental radiographic systems and conventional dental film.

OBJECTIVES: Digital radiography has become an integral part of dentistry. Digital radiography does not require film or dark rooms, reduces X-ray doses, and instantly generates images. The aim of our study was to compare the subjective image quality of two digital dental radiographic systems with conventional dental film. MATERIALS & METHODS: A direct digital (DD) 'Digital' system by Sirona, a semi-direct (SD) digital system by Vista-scan, and Kodak 'E' speed dental X-ray films were selected for the study. Endodontically-treated extracted teeth (n = 25) were used in the study. Details of enamel, dentin, dentino-enamel junction, root canal filling (gutta percha), and simulated apical pathology were investigated with the three radiographic systems. The data were subjected to statistical analyzes to reveal differences in subjective image quality. RESULTS: Conventional dental X-ray film was superior to the digital systems. For digital systems, DD imaging was superior to SD imaging. CONCLUSION: Conventional film yielded superior image quality that was statistically significant in almost all aspects of comparison. Conventional film was followed in image quality by DD, and SD provided the lowest quality images. Conventional film is still considered the gold standard to diagnose diseases affecting the jawbone. RECOMMENDATIONS: Improved software and hardware for digital imaging systems are now available and these improvements may now yield images that are comparable in quality to conventional film. However, we recommend that studies still use more observers and other statistical methods to produce ideal results.

Evaluation of mental foramen position from panoramic dental radiographs.

OBJECTIVE: Evaluate the position of mental foramen by measuring the vertical bone height from digital panoramic radiograph and also the variation of resorption pattern by gender and extraction time frame. Materials and methods/study design: Digital panoramic radiographs of 500 patients were reviewed. The study population was divided into four age groups aged 30 to 70 years as (30-39, 40-49, 50-59 and 60-70 years of age). Radiographic Position of mental foramen was evaluated in each panoramic radiograph by measuring the distance from the marginal bone to the mental foramen was being measured. Measurements were taken in each radiograph using Clini-view software. The data collected was subjected to statistical analysis using paired students t-test and chi-square tests. RESULTS AND CONCLUSION: In our study it was noted that the vertical measurements calculated from the superior margin of mental foramen to the crest of alveolar ridge were greater in edentulous men than in women. This measurement decreased significantly with age. We have noted here that resorption pattern between males and females can be used as an early diagnostic tool and for implant analysis. Studies comparing right and left side edentulous mandibular region are needed for further confirmation.

Age estimation using third molar teeth: A study on southern Saudi population.

OBJECTIVE: To estimate the age of an individual between 13 and 23 years, using Demirjian method in Saudi male patients in the southern region of the Kingdom of Saudi Arabia. MATERIALS AND METHODS: A total of 360 male patient's digital panoramic radiographs were used to evaluate the morphology of mandibular 3rd molar teeth roots according to the Demirjian method. Using descriptive statistical method, age was calculated. RESULTS: Result showed a strong relation of age with stages of root development of 3rd molar teeth. The standard deviation of mean of root development stages is 1.47 years of age. CONCLUSION: This study suggests that age can be predicted with a statistical significant result for ages between 13 and 23. Further studies with large population are needed for better statistical results and for female age assessment.